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Oh J, Kim E, Huh I. Associations between weekend catch-up sleep and health-related quality of life with focusing on gender differences. Sci Rep 2023; 13:20280. [PMID: 37985799 PMCID: PMC10662263 DOI: 10.1038/s41598-023-47244-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/10/2023] [Indexed: 11/22/2023] Open
Abstract
This study investigated associations between weekend catch-up sleep (WCUS) and health-related quality of life (HRQoL) in 15,837 participants from the 7th (2016-2018) Korea National Health and Nutrition Examination Survey. We categorized WCUS durations into four groups: none (≤ 0 h [h]), short (> 0 h, ≤ 1 h), medium (> 1 h, ≤ 2 h), and long (> 2 h), and performed complex samples logistic regression and likelihood ratio χ2 test. The study found significant associations in women for the European Quality of Life-5 Dimensions (EQ-5D) index and three EQ-5D subdomains (self-care, usual activities, and anxiety/depression) with the WCUS durations, but no significant association in men. Compared to the non-WCUS, the short or medium WCUS was positively associated with the EQ-5D index and EQ-5D subdomains (usual activities and anxiety/depression) in women, while the long WCUS significantly reduced the quality of life in the self-care domain. In an additional subgroup analysis by age, middle-aged and elderly women had a more noticeable effect of WCUS on HRQoL than young women, and the short or medium WCUS improved HRQoL in middle-aged and elderly women in general. Therefore, we recommend appropriate WCUS durations to improve HRQoL, considering both gender and age.
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Affiliation(s)
- Jinkyung Oh
- College of Nursing, Seoul National University, Seoul, 03080, Republic of Korea
| | - Eunmi Kim
- College of Nursing, Seoul National University, Seoul, 03080, Republic of Korea
| | - Iksoo Huh
- College of Nursing, Seoul National University, Seoul, 03080, Republic of Korea.
- The Research Institute of Nursing Science, Seoul National University, Seoul, 03080, Republic of Korea.
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Saki N, Hashemi SJ, Hosseini SA, Rahimi Z, Rahim F, Cheraghian B. Socioeconomic status and metabolic syndrome in Southwest Iran: results from Hoveyzeh Cohort Study (HCS). BMC Endocr Disord 2022; 22:332. [PMID: 36575435 PMCID: PMC9795639 DOI: 10.1186/s12902-022-01255-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/16/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Socioeconomic status (SES) strongly predicts morbidity and premature mortality, especially for non-communicable diseases (NCDs). However, the effect of these factors on Metabolic Syndrome (MetS) is not clear yet. This study was conducted to assess the relationship between socioeconomic indicators and MetS. METHODS In this prospective cohort study, 10,009 people aged 35-70 enrolled from May 2016 to August 2018. The MetS was defined according to The Standard National Cholesterol Education Program (NCEP)-adult treatment panel III (ATP III) or NCEP-ATP III criteria. Demographics and socioeconomic data were gathered face-to-face through trained interviews. Also, lab, anthropometrics, and blood pressure measurements were assayed for participants. Logistic regression was used to estimate the association between SES and MetS, adjusted for the potential confounding factors. RESULTS The overall prevalence of MetS in the participants was 39.1%. The crude odds ratios were statistically significant for all the assessed variables (p < 0.05). After adjustment for age, sex, physical activity, smoking, and alcohol use as potential confounders, the results indicated significant direct independent associations between skill level (p = 0.006) and Townsend index (p = 0.002) with MetS. In contrast, no significant associations between educational level and wealth status with MetS. CONCLUSION The results of our study showed that SES is related to MetS. Among the four assessed SES indicators, skilled levels and Townsend score are strongly associated with MetS. We recommend considering people's SES when interventional programs are planned and conducted on MetS in similar communities.
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Affiliation(s)
- Nader Saki
- Hearing Research Center, Clinical Sciences Research Institute, Department of Otolaryngology, Head and Neck Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Jalal Hashemi
- Department of Internal Medicine, School of Medicine, Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Ahmad Hosseini
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fakher Rahim
- Thalassemia and Hemoglobinopathy Research Center, Research Institute of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Strauss M, Lavie CJ, Lippi G, Brzęk A, Vollenberg R, Sanchis-Gomar F, Leischik R. A systematic review of prevalence of metabolic syndrome in occupational groups - Does occupation matter in the global epidemic of metabolic syndrome? Prog Cardiovasc Dis 2022; 75:69-77. [PMID: 36162483 DOI: 10.1016/j.pcad.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 12/14/2022]
Abstract
Many occupations can influence the development of metabolic syndrome (MetS). This systematic review aims to evaluate studies on MetS prevalence in different occupational groups from different countries. An integrative review of the literature was conducted within the PubMed and Web of Science databases between January 2005 and February 2022. Only studies with over 3000 subjects that presented data about the prevalence of MetS in different occupational groups were included. The classification of occupational groups was based on the statistical category of economic activities in the European Community (EC). Of a total of 1942 screened records, ten studies were included, showing that MetS is a common health (main) risk factor in all occupational groups. However, the prevalence of MetS varies between nationalities, between and within occupational groups, and between genders. The reasons for this variation appear complex and supported by several causal explanations. The prevalence of MetS was highest among women in a group of Korean skilled agricultural, forestry, and fishery workers (Prevalence: 39.2%). Similarly, among men, the highest prevalence was found in Korean equipment, machine operating, and assembling workers (Prevalence: 35.4%). Male information and communication technology professionals from the Netherlands (Prevalence: 6.2%) and Spanish female catering and hospitality, personal, and security service workers (Prevalence: 5.9%) had the lowest rates of MetS. Overall, the results indicated that valid data on this topic are insufficient, and more randomized controlled trials are needed. Moreover, the different definitions of MetS complicate the accurate comparison between studies, paving the way to achieving consensus on a universal definition of MetS.
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Affiliation(s)
- Markus Strauss
- Department of Cardiology I- Coronary and Periphal Vascular Disease, Heart Failure Medicine, University Hospital Muenster, Cardiol, 48149 Muenster, Germany; Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, 58455 Witten, Germany.
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School - The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Giuseppe Lippi
- Section of Clinical Biochemistry and School of Medicine, University of Verona, Verona, Italy
| | - Anna Brzęk
- Department of Physiotherapy, Chair of Physiotherapy, Faculty of Health Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Richard Vollenberg
- Department of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Muenster, 48149 Muenster, Germany
| | - Fabian Sanchis-Gomar
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
| | - Roman Leischik
- Department of Cardiology, Faculty of Health, School of Medicine, University Witten/Herdecke, 58455 Witten, Germany
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Effects of a Worksite-Based Self-Management Program in Traditional Retail Market Workers: Longitudinal Associations with Metabolic Parameters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052854. [PMID: 35270545 PMCID: PMC8910181 DOI: 10.3390/ijerph19052854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 11/30/2022]
Abstract
(1) Background: This study explored the effects of a worksite-based self-management program on metabolic parameters in traditional retail market workers during a 3-year period. (2) Methods: Seventy traditional retail market workers who completed 3 years of follow-up were included in this study. The worksite-based self-management program was developed to help traditional retail market workers manage metabolic parameters themselves based on the following content: (I) using a metabolic syndrome action checklist, (II) counseling, (III) creating improvement action plans, and (IV) evaluating implemented improvements. (3) Results: The rates of implemented improvements showed success. Fasting blood sugar and triglycerides showed yearly reductions from baseline for 3 years, which eventually led to a decreased metabolic syndrome score and maintenance of metabolic parameters in the normal range for 3 years. (4) Conclusions: A worksite-based self-management program on metabolic parameters in traditional retail market workers was effective. It improved their intention to self-assess and cope their health problems and eventually decreased their metabolic syndrome score. It should be considered for the primary prevention of metabolic syndrome among traditional retail market workers.
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Lin CY, Lin CM. Occupational Assessments of Risk Factors for Cardiovascular Diseases in Labors: An Application of Metabolic Syndrome Scoring Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207539. [PMID: 33081282 PMCID: PMC7589171 DOI: 10.3390/ijerph17207539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/14/2022]
Abstract
Unlike a traditional diagnosis of metabolic syndrome (MS), a numerical MS index can present individual fluctuations of health status over time. This study aimed to explore its value in the application of occupational health. Using a database of physiological and biochemical tests and questionnaires, data were collected from 7232 participants aged 20 to 64 years who received occupational health screenings at a health screening institution in 2018. Using confirmatory factor analysis, five components of MS were used to design an MS severity scoring index, which was then used to evaluate the risks of occupation factors. Waist circumference was the largest loading factor compared with the other MS components. Participants who worked in the traditional industrial, food processing, or electronic technology industries had higher MS severity than those in the logistics industry. Those who worked as a manager or over five years had a relatively high severity. The research showed that assessments based on an MS severity score are applicable when the risk factors of suboptimal health are involved. By monitoring the scores over time, healthcare professionals can propose preventive strategies in time, thus enhancing the effectiveness of occupational health examination services.
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Affiliation(s)
- Ching-Yuan Lin
- Department of Laboratory Medicine, Ten-Chan General Hospital, Chung Li, Taoyuan 320, Taiwan;
| | - Chih-Ming Lin
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-3-350-7001; Fax: +886-3-3593880
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Occupational Differences in C-Reactive Protein Among Working-Age Adults in South Korea. J Occup Environ Med 2019; 62:194-201. [PMID: 31790060 DOI: 10.1097/jom.0000000000001781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the association between occupational class and high-sensitivity C-reactive protein (hsCRP) in Korean workers. METHODS We used a nationally representative sample of Koreans (n = 2591) aged 19 to 65 years from the 2015 Korea National Health and Nutrition Examination Survey. The concentration of hsCRP (mg/L) was assessed by a high sensitivity immunoturbidimetric assay. Current occupation was categorized as: white-collar (managers/professionals), pink-collar (clerks/service/sales), blue-collar (craft/equipment/machine-assembling, agricultural/forestry/fishery, and elementary-level labor), or unemployed. Cross-sectional linear regression models adjusted for sociodemographic/work-related/health conditions and behaviors. RESULTS Compared with blue-collar workers, white-collar workers showed significantly higher levels of hsCRP (β = 0.16, 95% CI: 0.02, 0.30) after adjusting for all covariates, whereby the pattern was more pronounced among professionals. However, the association was not significant for unemployed and pink-collar workers. CONCLUSIONS Findings suggest that Korean white-collar workers, particularly professionals, have elevated levels of inflammation.
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Cho DY, Koo JW. Differences in Metabolic Syndrome Prevalence by Employment Type and Sex. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091798. [PMID: 30134584 PMCID: PMC6165279 DOI: 10.3390/ijerph15091798] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 01/07/2023]
Abstract
Workers may sometimes do the same work, but differ in their risk of health-related problems depending on whether the employment type is standard or non-standard. Furthermore, even with similar job and employment types, there may be differences in risk factors for health-related problems depending on sex. This study aimed to determine the prevalence of metabolic syndrome (MetS) by employment type and sex using data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES Ⅴ) (2010–2012) and KNHANES Ⅵ (2013–2015) conducted by the Korea Centers for Disease Control and Prevention. Overall, 9523 adult wage workers (5523 standard workers and 4000 non-standard workers) aged ≥ 19 years were analyzed. To determine MetS prevalence odds ratios according to employment type, logistic regression analysis was performed disaggregated by sex. The prevalence of MetS significantly increased with age (p < 0.001), being married (p < 0.05), current smoking status (p < 0.05), and high-risk drinking (p < 0.001) among male subjects. The prevalence of MetS significantly increased among female manual workers (p < 0.001), those with lower educational level and household income (p < 0.001). Non-standard workers of either sex showed higher MetS prevalence than standard workers; only females showed significant difference (p < 0.001). Female non-standard workers showed 1.44, 1.33, and 1.34 (all p < 0.001) times higher odds of MetS prevalence in Models 1, 2, and 3, respectively, compared to standard workers, suggesting a difference in risk factors of MetS according to sex. Also, that employment type affects MetS prevalence suggests that employment pattern is an important risk factor especially in females. Therefore, to manage MetS in female non-standard workers, individual health care as well as social effort may be necessary.
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Affiliation(s)
- Duk Youn Cho
- Department of Rehabilitation and Assistive Technology, Korea National Rehabilitation Center, Seoul 01022, Korea.
| | - Jung-Wan Koo
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
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Choi JR, Kim JY, Park IH, Huh JH, Kim KW, Cha SK, Park KS, Sohn JH, Park JT, Koh SB. Serum Fibroblast Growth Factor 21 and New-Onset Metabolic Syndrome: KoGES-ARIRANG Study. Yonsei Med J 2018; 59:287-293. [PMID: 29436198 PMCID: PMC5823832 DOI: 10.3349/ymj.2018.59.2.287] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/21/2017] [Accepted: 12/02/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Fibroblast growth factor 21 (FGF21) is a crucial metabolic regulator, with multiple favorable effects on glucose homeostasis and lipid metabolism. Since serum FGF21 level has been implicated as a potential marker for the early identification of metabolic syndrome (MetS), we investigated the association between serum FGF21 level and the development of MetS in a population-based prospective study. MATERIALS AND METHODS We conducted a prospective study of 221 randomly sampled adults without MetS from a general population-based cohort study who were examined from 2005-2008 (baseline) and from 2008-2011 (follow-up). Baseline serum FGF21 levels were analyzed using enzyme-linked immunosorbent assay. RESULTS During the average 2.8-year follow-up period, 82 participants (36.6%) developed new-onset MetS. Serum FGF21 levels were significantly higher in patients with new-onset MetS than in those without MetS (209.56±226.80 vs. 110.09±81.10, p<0.01). In multivariate adjusted models, the odds for MetS development were greater in patients with serum FGF21 levels in the highest quartile, compared to those in the lowest quartile (3.84, 95% confidence interval: 1.59-9.28). CONCLUSION Serum FGF21 level was an independent predictor for new-onset MetS in a population-based prospective study.
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Affiliation(s)
- Jung Ran Choi
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jang Young Kim
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Il Hwan Park
- Department of Thoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ji Hye Huh
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Ki Woo Kim
- Department of Pharmacology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seung Kuy Cha
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Kyu Sang Park
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Joon Hyung Sohn
- Mitohormesis Research Center, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jong Taek Park
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Sang Baek Koh
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Ryu H, Chin DL. Factors associated with metabolic syndrome among Korean office workers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2017; 72:249-257. [PMID: 27285063 DOI: 10.1080/19338244.2016.1200004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
To assess the prevalence of metabolic syndrome (MetS) and identify risk factors associated with MetS among Korean office workers, this cross-sectional study was conducted with 776 office workers. The prevalence of MetS was 13.5%; elevated waist circumference (27.5%), elevated fasting glucose (23.1%), elevated triglycerides (22.2%), low high-density lipoprotein cholesterol (HDL-C) (13.4%), and elevated BP (9.4%). Having any medical health problems (OR = 3.98, 95% CI: 2.01-7.85), more knowledge of MetS (OR = 1.26, 95% CI: 1.02-1.56), higher BMI (OR = 1.42, 95% CI: 1.30-1.57), current smoking (OR = 3.78, 95% CI: 1.04-13.73), and physical inactivity (OR = 3.22, 95% CI: 1.21-8.58) were significantly associated with increased likelihood of MetS. Addressing the influence of these factors on MetS could lead to the development of workplace-based intervention strategies to encourage lifestyle changes and prevent the risk of MetS among Korean office workers.
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Affiliation(s)
- Hosihn Ryu
- a College of Nursing , Korea University , Seoul , Republic of Korea
| | - Dal Lae Chin
- b School of Nursing , University of California San Francisco , San Francisco , California , USA
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Seo JM, Lim NK, Lim JY, Park HY. Gender Difference in Association with Socioeconomic Status and Incidence of Metabolic Syndrome in Korean Adults. ACTA ACUST UNITED AC 2016. [DOI: 10.7570/kjo.2016.25.4.247] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Jeong Mi Seo
- Division of Cardiovascular and Rare Disease, Korea National Institute of Health, Cheongju, Korea
| | - Nam-Kyoo Lim
- Division of Cardiovascular and Rare Disease, Korea National Institute of Health, Cheongju, Korea
| | - Joong Yeon Lim
- Division of Cardiovascular and Rare Disease, Korea National Institute of Health, Cheongju, Korea
| | - Hyun-Young Park
- Division of Cardiovascular and Rare Disease, Korea National Institute of Health, Cheongju, Korea
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Kim CJ, Schlenk EA, Kang SW, Park JB. Effects of an internet-based lifestyle intervention on cardio-metabolic risks and stress in Korean workers with metabolic syndrome: a controlled trial. PATIENT EDUCATION AND COUNSELING 2015; 98:111-119. [PMID: 25468401 DOI: 10.1016/j.pec.2014.10.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 09/21/2014] [Accepted: 10/19/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE This study examined the effects of an Internet-based Best Exerciser Super Trainer (BEST) program on cardio-metabolic risks and stress among workers with metabolic syndrome. METHODS This study utilized a non-randomized, pretest, and posttest, controlled design with a convenience sample of 48 Korean male workers. The workers in the BEST group participated in a 16-week Internet-based program: 150 min of regular physical activity per week, 200- to 300-kcal reduced daily diet for weight control, one-on-one counseling, and mobile phone text messages. Workers in the Education group received text messages and an educational booklet. RESULTS There were significant group by time interactions in cardio-metabolic risks: body weight (p = .022), visceral fat mass (p = .033), and waist circumference (p = .037). There was no group by time interaction in stress (p > .05); however, the BEST group showed a significantly greater reduction in health-related stress than those in the Education group (p = .025). CONCLUSION This study yielded evidence of the beneficial impact of the Internet-based BEST program for workers with metabolic syndrome on selected cardio-metabolic risks and health-related stress. PRACTICE IMPLICATIONS Internet-based one-on-one counseling and mobile phone text messages can assist individuals with targeted lifestyle modifications for metabolic syndrome.
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Affiliation(s)
- Chun-Ja Kim
- Department of Adult Health Nursing, Ajou University College of Nursing, Suwon, South Korea.
| | | | - Se-Won Kang
- College of Nursing and Healthcare Science, Dong-Eui University, Busan, South Korea
| | - Jae-Bum Park
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, South Korea
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